| NPI | 1538601646 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MD 05823) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NY 021807) |
| 103TC0700X Psychologist, Clinical (Licence: VA 0810005339) | |
| Enumeration Date | 2016-11-07 |
| Last Update Date | 2021-01-15 |